Insurance companies in the District of Columbia have been ordered to stop denying coverage to transgender residents seeking gender-reassignment surgery.

Mayor Vincent Gray says the new rules will end health-care discrimination against the transgender population and put "the district at the forefront of advancing the rights of transgender individuals.''

A bulletin issued Thursday by the city's Department of Insurance, Securities and Banking says that gender dysphoria is a recognized medical condition. It says the various forms of treatment for that condition, including sex-change procedures, are covered benefits.

Gray says people with gender dysphoria, also known as gender identity disorder, "should not have to pay exorbitant out-of-pocket expenses for medically necessary treatment.''

Allowing transition-related care is absolutely vital to allow transgender people to live full, good lives," said activist Andy Bowen of the National Center for Transgender Equality.

The city already has laws banning discrimination against transgender people. Health care is as vital as efforts to curb violence against transgender people, according to the Gray administration.

Mara Keisling, who runs the National Center for Transgender Equality, told News4's Tom Sherwood there are still other areas of discrimination, like in employment, but access to health care is vital.

Costs for counseling, medicines and gender surgeries can total tens of thousands of dollars, an especially large burden for lower-income people facing job discrimination.